The effect of high-tone external muscle stimulation on symptoms and electrophysiological parameters of uremic peripheral neuropathy

Strempska, Beata; Bilińska, Małgorzata; Weyde, Wacław; Koszewicz, Magdalena; Madziarska, Katarzyna; Gołębiowski, Tomasz; Klinger, Marian

doi:10.5414/cnx77s103

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…In ESRD patients our group could demonstrade that HTEMS improves pain and discomfort due to peripheral neuropathy as well as sleep disturbances [25]. These data were recently confirmed and extended [26].…”

Section: Introductionsupporting

confidence: 75%

High-tone external muscle stimulation in endstage renal disease: effects on quality of life in patients with peripheral neuropathy

Klassen¹,

Racasan²,

Gherman-Caprioara³

et al. 2012

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Objective: High-tone external muscle stimulation (HTEMS) has been shown to ameliorate painful peripheral neuropathy of dialysis patients. We hypothesized that HTEMS could also lead to improved parameters of health-related quality of life (HRQOL). Methods: 25 end-stage renal disease (ESRD) patients (17 men/8 women, mean age 62.2 ± 14.2 years) were enrolled for the study. For evaluation of HRQOL the short form SF-36 was used. In addition, the Hospital Anxiety and Depression Scale (HADS) and the pain severity score were investigated. HTEMS was applied intradialytically for 1 hour, 3 times a week. Its effect was evaluated just before the beginning and both 6 and 12 weeks after onset of this study. Results: SF-36 showed a significant effect of time for the subscales of physical role functioning and social functioning. A marginal significant positive trend could be observed for physical functioning. The pain symptom questionnaire sum scores improved significantly after 12 weeks. The HADS did not change significantly. Conclusion: The data indicate that intradialytic HTEMS treatment of ESRD patients with peripheral neuropathy ameliorates various components of physical health.

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Section: Introductionsupporting

confidence: 75%

High-tone external muscle stimulation in endstage renal disease: effects on quality of life in patients with peripheral neuropathy

Klassen¹,

Racasan²,

Gherman-Caprioara³

et al. 2012

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“…Therefore, the persistence of the analgesic action of HTEMS over a period of one year is a strong indicator of the impact of this kind of therapy. Meanwhile, the efficacy of HTEMS in dialysis patients with peripheral neuropathy has been confirmed and extended [80].…”

Section: High Tone External Muscle Stimulationmentioning

confidence: 93%

Neuromuscular electrostimulation techniques: historical aspects and current possibilities in treatment of pain and muscle waisting

Heidland

Fazeli²,

Klassen³

et al. 2012

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Application of electricity for pain treatment dates back to thousands of years BC. The Ancient Egyptians and later the Greeks and Romans recognized that electrical fishes are capable of generating electric shocks for relief of pain. In the 18 th and 19 th centuries these natural producers of electricity were replaced by man-made electrical devices. This happened in following phases. The first was the application of static electrical currents (called Franklinism), which was produced by a friction generator. Christian Kratzenstein was the first to apply it medically, followed shortly by Benjamin Franklin. The second phase was Galvanism. This method applied a direct electrical current to the skin by chemical means, applied a direct and pulsed electrical current to the skin. In the third phase the electrical current was induced intermittently and in alternate directions (called Faradism). The fourth stage was the use of high frequency currents (called d'Arsonvalisation). The 19 th century was the "golden age" of electrotherapy. It was used for countless dental, neurological, psychiatric and gynecological disturbances. However, at beginning of the 20 th century electrotherapy fell from grace. It was dismissed as lacking a scientific basis and being used also by quacks and charlatans for unserious aims. Furthermore, the development of effective analgesic drugs decreased the interest in electricity. In the second half of the 20 th century electrotherapy underwent a revival. Based on animal experiments and clinical investigations, its neurophysiological mechanisms were elucidated in more details. The pain relieving action of electricity was explained in particular by two main mechanisms: first, segmental inhibition of pain signals to the brain in the dorsal horn of the spinal cord and second, activation of the descending inhibitory pathway with enhanced release of endogenous opioids and other neurochemical compounds (serotonin, noradrenaline, gamma aminobutyric acid (GABA), acetylcholine and adenosine). The modern electrotherapy of neuromusculo-skeletal pain is based in particular on the following types: transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation (PENS or electro-acupuncture) and spinal cord stimulation (SCS). In mild to moderate pain, TENS and PENS are effective methods, whereas SCS is very useful for therapy of refractory neuropathic or ischemic pain. In 2005, high tone external muscle stimulation (HTEMS) was introduced. In diabetic peripheral neuropathy, its analgesic action was more pronounced than TENS application. HTEMS appeared also to have value in the therapy of symptomatic peripheral neuropathy in end-stage renal disease (ESRD). Besides its pain-relieving effect, electrical stimulation is of major importance for prevention or treatment of muscle dysfunction and sarcopenia. In controlled clinical studies electrical myostimulation (EMS) has been shown to be effective against the sarcopenia of patients with chronic congestive heart disease, diabetes, chronic obstr...

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“…Weakness and atrophy of lower extremities follow the sensory symptoms. With disease progression, these symptoms move proximally and involve the upper extremities . Muscle cramps and restless legs syndrome were reported by 67% of uremic patients.…”

Section: Introductionmentioning

confidence: 99%

Polyneuropathy associated with chronic hemodialysis: Clinical and electrophysiological study

et al. 2018

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| INTRODUC TI ONNeuropathies associated with metabolic diseases typically present with a slowly progressive, distal symmetric sensorimotor polyneuropathy (DSPN) with paresthesia, impaired vibration sense, reduction in deep tendon reflexes, muscle wasting, and weakness which characteristically progress over the course of months, but can occasionally take a faster course, triggering marked disability. 1 Patients may also develop autonomic features, with postural hypotension, impaired sweating, diarrhea, constipation or impotence. 2 Mononeuropathies in the form of compressive neuropathy can occur in the median nerve at the wrist, in the ulnar nerve at the elbow, or in the peroneal nerve at the fibular head. 3Regarding peripheral neuropathy due to renal failure (uremic neuropathy), approximately 60%-90% of patients with chronic kidney disease (CKD), especialy stage 5 on hemodialysis: glomerular filtration rate <12 mL/min) develop DSPN. 4 Abstract Aim: To estimate the frequency and pattern of peripheral polyneuropathy (PNP) that may affect patients maintained on hemodialysis. Patients and methods:The study was carried out on 60 middle-aged male patients attending the Internal Medicine Department for maintenance hemodialysis. All were subjected to a complete neurological examination. Motor and sensory nerve conduction studies of both lower limbs (the tibial, peroneal and sural nerves) and both upper limbs (median and ulnar nerves), as well as F-wave measurements of both tibial and median nerves, were done. The patients were subdivided clinically into two groups, clinically apparent neuropathy and inapparent groups. Then they were divided according to the types of peripheral neuropathy detected by electrophysiological studies into axonal, demyelinated and mixed polyneuropathy. In addition, they were divided into motor, sensory and sensorimotor groups. Results:Polyneuropathy was found clinically presented in 33 (55%) cases, while evident by electrophysiological examination in 100% of the clinically apparent group (33 patients) and evident in 92.5% of the clinically inapparent group (27 patients). The frequency of pathologic electrophysiological parameters was significantly higher in patients with longer duration of hemodialysis. Axonal polyneuropathy is the most prevalent type in those patients. Conclusion:Peripheral polyneuropathy is a common presentation in patients maintained on hemodialysis. The longer the duration of hemodialysis, the more liability to develop PNP that can be detected earlier by electrodiagnostic studies in the subclinical cases. K E Y W O R D S electrodiagnosis, hemodialysis, peripheral neuropathy | 827 EZZELDIN Et aL. How to cite this article: Ezzeldin N, Abdel Galil SM, Said D, Kamal NM, Amer M. Polyneuropathy associated with chronic hemodialysis: Clinical and electrophysiological study. Int J

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The effect of high-tone external muscle stimulation on symptoms and electrophysiological parameters of uremic peripheral neuropathy

Cited by 9 publications

References 7 publications

High-tone external muscle stimulation in endstage renal disease: effects on quality of life in patients with peripheral neuropathy

High-tone external muscle stimulation in endstage renal disease: effects on quality of life in patients with peripheral neuropathy

Neuromuscular electrostimulation techniques: historical aspects and current possibilities in treatment of pain and muscle waisting

Polyneuropathy associated with chronic hemodialysis: Clinical and electrophysiological study

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